What Sort Of Germs Could Be Hiding In Your Endoscopy Equipment?

Anyone who works in the medical industry should know how important it is to clean endoscopy equipment between patients, which can be quite challenging at the best of times. On the very odd occasion, you will hear of cases where poorly cleaned equipment has spread harmful pathogens around patients, leading to severe sickness and in some cases death. There are a number of pathogens that could be lurking in the nooks and crannies of endoscopy instruments, such as:

Gram-Negative Bacilli

  • Pseudomonas aeruginosa
  • Klebsiella
  • Enterobacter
  • Serrata marcesans
  • Salmonella
  • Heliobacter pylori
  • Bacillus
  • Proteus

Mycobacteria

  • Mycobacterium tuberculosis
  • Atypical microbacteria

Funghi

  • Trichrosporon
  • Rhodotorula rubra

Parasites

  • Strongyloides

Viruses

  • Hepatitis B
  • Hepatitis C

Often, endogenous or exogenous microbes are responsible for infections related to endoscopy equipment. Experts have pinpointed that these sorts of infections can include:

Endogenous

  • Cholangitis (from the manipulation of a blocked biliary tract);
  • Pneumonia (from aspiration of oral secretions); and
  • Endocarditis (from bacteremia).

Exogenous

  • Poor manual cleaning;
  • Insufficient exposure of surfaces to disinfectants;
  • Insufficient rinsing or drying; and
  • Use of automated reprocessors.

It is worth delving into which type of endoscopy equipment and procedures will merit sterilization rather than high-level disinfection. All “critical devices” should undergo a full sterilization, for example. This includes any devices that enter sterile tissue or body spaces. All “semi-critical devices” should undergo high-level disinfection, on the other hand. This includes equipment that enters mucous membranes or non-intact skin. All “non-critical devices” should undergo low-level germicide (or cleaning with simple detergent and water). This includes instruments that contact intact skin.

Endoscopy instruments are classified as semi-critical, unless they enter sterile body cavities at which point they are considered as critical. Some accessories are actually considered critical at all times. If your equipment only requires high-level disinfection, however, you should opt for one of the following disinfectants:

Glutaraldehyde

  • This type should come into contact with all internal and external surfaces and channels for at least 20 minutes.

Hydrogen Peroxide

  • This type is only suitable for endoscopy instruments if the accompanying instructions say so, as it can damage rubber, plastics and metals.

Peracetic Acid

  • This type has actually been connected to several health hazards, including severe burns from direct skin contact and irreversible damage or blindness.

Peracetic Acid with Hydrogen Peroxide

  • The combination of these substances has been approved by health boards for sterilizing semi-critical medical equipment.

Orthophalaldehyde

  • This type apparently has several advantages over the first disinfectant and it doesn’t require activation before use.

Super-Oxidised Water

  • This type has only been approved by health boards for high-level disinfection in the last 10 years or so.

It is important that your endoscopy equipment has been cleaned appropriately, otherwise you risk infecting your patients with any number of the pathogens that have been outlined above. You could even risk infecting yourself or one of your staff if you were to accidentally come into contact with the instruments with bare skin. Make sure that your staff are using one of the above approved disinfectants to clean the equipment to ensure health and safety.